Montplaisir J, Petit D, Décary A, Masson H, Bédard M A, Panisset M, Rémillard G, Gauthier S
Centre d'étude du sommeil, Hôpital du Sacré-Coeur/Université de Montréal, Québec, Canada.
Neurology. 1997 Oct;49(4):999-1003. doi: 10.1212/wnl.49.4.999.
Sleep architecture and quantitative EEG from wakefulness and REM sleep were studied in six patients (mean age, 70.5 years) with progressive supranuclear palsy (PSP) and compared with that of six control subjects (mean age, 69.8 years). Particular attention was given to quantifying REM sleep variables because of the known PSP-associated degeneration of the pedunculopontine tegmentum (PPT)--a critical structure in REM sleep generation. Patients with PSP had a shorter total sleep time, a lower sleep efficiency, a drastic reduction in sleep spindles, an atonic slow-wave sleep, and a lower percentage of REM sleep. The lower percentage of REM sleep was the result of both a reduction in the number of REM periods and a reduction in mean period of duration. REM density was also reduced while REM efficiency, atonia, and phasic EMG were similar to control values. REM sleep findings are consistent with the known role of the PPT in REM sleep induction. A slowing of the awake EEG was found for the six frontal leads and for C4, P4, and T4 in PSP patients. The frontal EEG slowing found in wakefulness is in accord with imaging and neuropsychological studies showing impairment of the frontal lobes in these patients. REM sleep EEG was not significantly slower in any regions. Because all previous studies on PSP have relied on visual inspection of the EEG tracings, the present finding of EEG slowing in the frontal lobes (rather than in the temporal regions or diffusely) suggests that our quantitative EEG approach may be more useful in determining specific regions of impaired cortical activity.
对6例进行性核上性麻痹（PSP）患者（平均年龄70.5岁）的睡眠结构以及清醒和快速眼动（REM）睡眠期的定量脑电图进行了研究，并与6名对照受试者（平均年龄69.8岁）进行了比较。由于已知PSP相关的脑桥被盖脚间核（PPT）——REM睡眠产生的关键结构——发生变性，因此特别关注对REM睡眠变量进行量化。PSP患者的总睡眠时间较短、睡眠效率较低、睡眠纺锤波急剧减少、出现张力缺乏性慢波睡眠以及REM睡眠百分比降低。REM睡眠百分比降低是REM期数量减少和平均时长缩短共同作用的结果。REM密度也降低，而REM效率、张力缺乏和相位肌电图与对照值相似。REM睡眠的研究结果与PPT在REM睡眠诱导中的已知作用一致。在PSP患者中，发现六个额导联以及C4、P4和T4导联的清醒脑电图出现减慢。清醒时发现的额叶脑电图减慢与影像学和神经心理学研究结果一致，这些研究表明这些患者存在额叶功能障碍。REM睡眠脑电图在任何区域均未显著减慢。由于之前所有关于PSP的研究都依赖于对脑电图描记图的目视检查，因此目前额叶脑电图减慢（而非颞叶区域或弥漫性减慢）的发现表明，我们的定量脑电图方法在确定皮质活动受损的特定区域方面可能更有用。
